SPRAVATO® (Esketamine)

When Traditional Antidepressants Aren’t Enough

For many people with depression, standard antidepressant medications provide meaningful relief. But for others—those with treatment-resistant depression (TRD)—two or more antidepressants tried at adequate doses and durations still haven’t been enough. If that describes your experience, you’re not alone, and you’re not out of options.

SPRAVATO (esketamine) nasal spray represents a fundamentally different approach to treating depression. Unlike traditional antidepressants that target the serotonin system, SPRAVATO works on the glutamate system—the brain’s most abundant neurotransmitter—which plays a critical role in neural communication, plasticity, and mood regulation.

How SPRAVATO Works

SPRAVATO is an NMDA receptor antagonist. By modulating glutamate signaling, it promotes the growth of new neural connections—a process called synaptogenesis—that can help restore brain pathways affected by chronic depression. This mechanism is why SPRAVATO can produce noticeable improvement within hours to days, compared to the weeks or months that traditional antidepressants often require.

Who Is SPRAVATO For?

SPRAVATO is FDA-approved for:

• Treatment-resistant depression (TRD) in adults—defined as major depressive disorder that has not responded adequately to at least two oral antidepressants in the current episode. SPRAVATO can be used as a standalone treatment or alongside an oral antidepressant.
• Major depressive disorder with acute suicidal ideation or behavior in adults—used in conjunction with an oral antidepressant for patients who need rapid symptom relief.

What to Expect During Treatment

SPRAVATO is administered in our REMS-certified clinic under direct medical supervision. Here’s what a typical session looks like:

1. Preparation — Avoid food for 2 hours and liquids for 30 minutes before your appointment.
2. Self-administration — You self-administer the nasal spray under your provider’s observation. It’s similar to using a nasal decongestant—no IVs or injections.
3. Monitoring period — You rest comfortably in our clinic for a minimum of 2 hours while our team monitors your blood pressure, heart rate, and overall well-being.
4. Departure — After your monitoring period, you’ll be released to a caregiver who drives you home. You should not drive or operate machinery for the rest of the day.

Total appointment time is approximately 2 to 2.5 hours.

Treatment Schedule

• Weeks 1–4 (Induction) — Twice-weekly sessions to establish a therapeutic response.
• Weeks 5–8 (Initial Maintenance) — Once-weekly sessions to sustain improvement.
• Week 9+ (Long-term Maintenance) — Sessions once weekly or every two weeks, individualized to the least frequent schedule that maintains your progress.

Clinical Results

In clinical trials, SPRAVATO has demonstrated meaningful outcomes for patients with treatment-resistant depression:

• Statistically significant improvement within 24 hours in monotherapy trials
• 22.5% of patients achieved remission at Week 4 with SPRAVATO monotherapy, compared to 7.6% with placebo
• In long-term studies, 76% of participants remained in treatment for 2 or more years
• Real-world evidence shows 71% of patients achieved substantial clinical improvement at 12 months

Safety & Side Effects

SPRAVATO is a Schedule III controlled substance administered only in certified healthcare settings. The most common side effects include:

• Dissociation (a temporary feeling of disconnection from your surroundings)
• Sedation or drowsiness
• Dizziness
• Nausea
• Temporary increase in blood pressure

These effects typically begin within 5–10 minutes of treatment and resolve within 30–90 minutes during your monitoring period. Our clinical team is with you throughout the entire process to ensure your comfort and safety.

Why Choose Sentry for SPRAVATO?

At Sentry Integrative Mental Health, SPRAVATO is part of a comprehensive, whole-person treatment approach—not an isolated intervention. We consider your full clinical picture, including medications, therapy, lifestyle factors, and overall wellness, to ensure SPRAVATO is the right fit and that you’re getting the most from every treatment session.

Our REMS-certified clinic provides a calm, supportive environment where you can feel safe and cared for during each visit. We believe that how you experience treatment matters as much as the treatment itself.